Bennett, Kinneathea Denisha

Bennett, Kinneathea Denisha is an individual health care provider with primary practice located at 5414 Fredericksburg Rd Ste 100A , San Antonio TX 78229-3641. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Bennett, Kinneathea Denisha can be contacted via phone (210) 468-0800.

Contact Information

Primary practice address
5414 Fredericksburg Rd Ste 100A San Antonio TX 78229-3641
Phone: (210) 468-0800
Fax: (210) 733-8649
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X AP133353 Texas

Profile Details

NPI number 1902346141
LBN Legal business name Bennett, Kinneathea Denisha
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2017
Last updated Sep 29th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902346141 NPPES
Texas MEDICAID 370823204
Texas Other AG0117008

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